Finding The Cause

University of Liverpool scientists have found an enzyme that may be the culprit causing the condition known as endometriosis, the main reason for chronic female pelvic pain. In endometriosis, tissue mimicking that of the inner lining of the uterus is found outside the uterine cavity. The condition affects up to 15% of all women of childbearing age, causing severe pain and conception difficulties. Half of all infertile women are affected by endometriosis.

Unique Enzyme

The Liverpool team discovered that an enzyme known as telomerase is excreted by the endometrial cells during the late stages of the female menstrual cycle in those women affected by endometriosis. This enzyme is unique to certain body cells, such as those found in the cells of the uterine lining, in the eggs, and in sperm. Telomerase is also found in cancer cells and is believed to be behind the replication of DNA sequencing during chromosomal cell division.

Liverpool University's Dr. Dharani Hapangama of the Department of Reproductive and Developmental Medicine explains that his team found the telomere, an end section of every chromosome that serves as a guard against damage during cell division, to be of abnormal length in women with endometriosis. In general, menstruation causes the telomeres to shorten in length at each cycle of cell division until they have reached a length at which they cannot continue to divide.

Cell Division

An enzyme such as the one found by Hapangama's team, telomerase, serve to prolong the length of the telomeres so that the cells continue the process of division. This is what happens in sperm and egg cells, and in other special cells, but isn't the normal state of being for cells found elsewhere in the body. Says Hapangama, “Our research shows, however, that cells in the lining of the womb are unique in that they can express this enzyme in the early stages of the menstrual cycle when cell division is important, but not during the latter stages when implantation of the fertilized embryo becomes a priority."

Hapangama goes on to explain that women who have the condition endometriosis give off telomerase both in the early and the late stages of their menstrual cycles which assures that the cells will continue to divide, thus losing their ability to focus on and support a possible pregnancy. He believes that the result of this abnormal excretion of telomerase causes the endometrium of such women to be less conducive to early pregnancy, but more liable to survive, migrate and implant outside the cavity of the uterus, causing pelvic or abdominal pain.

The research team hopes these findings will aid scientists in their search for new techniques which can diagnose and treat endometriosis.